Find a CMS Data File
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Durable Medical Equipment RIF
The Durable Medical Equipment (DME) file contains final action, fee-for-service claims submitted by Durable Medical Equipment suppliers. This file includes: ...
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Skilled Nursing Facility RIF
The Skilled Nursing Facility ( SNF ) file contains final action, fee-for-service, claims data submitted by SNF providers. ...
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Carrier RIF
The Carrier file (also known as the Physician/Supplier Part B claims file) contains final action fee-for-service claims submitted on a CMS -1500 claim form. Most of the claims are from non-institutional providers, such as physicians, physician assistants, ...
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MedPAR RIF
The MedPAR File contains inpatient hospital and skilled nursing facility ( SNF ) final action stay records. Each MedPAR record represents a stay in an inpatient hospital or SNF. Each MedPAR record may represent one claim or multiple claims, depending on ...
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Master Beneficiary Summary File
The Master Beneficiary Summary File includes several segments. Base (A/B/D) segment : This segment includes beneficiary enrollment information, such as the beneficiary unique identifier, state and county codes, zipcode, date of birth, date of death, sex, ...
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Inpatient RIF
The Inpatient file contains final action fee-for-service claims data submitted by inpatient hospital providers for reimbursement of facility costs. This file includes: diagnosis (ICD-9 diagnosis), procedure (ICD-9 procedure code), Medicare Severity ...
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Outpatient RIF
The Outpatient file contains final action, fee-for-service claims data submitted by institutional outpatient providers. Examples of institutional outpatient providers include hospital outpatient departments, rural health clinics, renal dialysis facilities ...
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Denominator RIF
The Denominator File contains demographic and enrollment information about each Medicare beneficiary during a calendar year. The information in the Denominator File is 'frozen' in March of the following calendar year. This file is not ...
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MAX Personal Summary File
The Personal Summary File contains one record for every individual enrolled for at least one day during the year. The file contains demographic data (e.g. date of birth, gender, race), basis of eligibility, maintenance assistance status, monthly ...
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MAX Other Therapy File
The Other Therapy File contains claim records for a variety of Medicaid services, including physician services, lab/X-ray, clinic services, home health, hospice and premium payments. Outpatient hospital institutional claims are also included in this file ...
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MAX Inpatient File
The Inpatient File contains complete stay records for enrollees who used inpatient services including diagnoses, procedures, discharge status, length of stay, and payment amount. The MAX Inpatient File contains 10 diagnostic fields and 7 procedure fields. ...
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MAX Prescription Drug File
The Drug File contains final action, paid drug claims. Since 1996, the dispensed drug has been identified by an NDC . Drugs or supplies identified by HCPCS ( CMS Health Care Common Proceedure Codes) or any state-specific codes, are included in the MAX ...
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MAX Long Term Care File
The Long Term Care File contains claims for institutional long term care services provided by Nursing Facilities, Intermediate Care Facilities (ICFs), and independent psychiatric facilities. Fields include facility type, dates of service, and discharge ...
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Part D Drug Event File
The PDE data contain prescription drug costs and payment data that enable CMS to make payments to the plans and otherwise administer the Part D benefit. When a beneficiary fills a prescription under Medicare Part D, a prescription drug plan sponsor must ...
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Part D Formulary File
This is a CMS data file, available for request and use in analysis. Short Name: Part D Formulary File Category: Prescription Drugs Privacy Level: Research Identifiable Files Program: Medicare Qualified Entity Program File Version: 2010 Attachment ...
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Medicare-Medicaid Linked Enrollee Analytic Data Source
The Medicare-Medicaid Linked Enrollee Analytic Data Source (MMLEADS) has been developed to allow for the examination of all Medicare and Medicaid enrollment and claims data for those who were dually enrolled in both programs. The current files are ...
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Vital Status File with Name and Address
The Vital Status File with Name and Address contains demographic information about each beneficiary ever entitled to Medicare. This file is often used to contact Medicare beneficiaries for participation in a study, geocoding beneficary residence, ...
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Beneficiary Summary File
The Beneficiary Summary File includes the beneficiary unique identifier, state and county codes, zipcode, date of birth, date of death, sex, race, age, monthly entitlement indicators (A/B/C/D), reasons for entitlement, and monthly managed care ...
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Health and Retirement Survey- Medicare Linked Data
One of the main goals of the Health and Retirement Study (HRS) is to understand the relationship between medical history and financial status, and how use of health care may change as people age. To assist in this effort, the HRS endeavors to ...
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Beneficiary Annual Summary File
The Beneficiary Annual Summary File is a beneficiary level file that contains enrollment, eligibility, vital statistics, summarized service utilization and payment, and CCW chronic condition flags. The last year of this file is calendar ...
